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Sorry To Bother You Again But I Will Undoubtably Give
Question: Sorry to bother you again but I will undoubtably give you another 5 star.
My GI says RUQ pain which we have been given many tests like you may remember as MRI abdomen, Ultrasound, Endoscopy and Colonoscopy. He saying IBS or he next going to do a HIDA scan thinking gall bladder. You looked at all tests previously that you can relook at including blood tests that said no liver scarring or inflammation I believe?
Here’s my question. The one report I think the ultrasound said hyperecholic consistent with steatosis. Could this be causing my RUQ discomfort? Does this mean simple fatty liver of 5-10% fat? Can I fix with weight loss, no alcohol, and extra Virgin olive oil? I’m also taking 800 mg Vitamin E and milk thistle.
My GI says RUQ pain which we have been given many tests like you may remember as MRI abdomen, Ultrasound, Endoscopy and Colonoscopy. He saying IBS or he next going to do a HIDA scan thinking gall bladder. You looked at all tests previously that you can relook at including blood tests that said no liver scarring or inflammation I believe?
Here’s my question. The one report I think the ultrasound said hyperecholic consistent with steatosis. Could this be causing my RUQ discomfort? Does this mean simple fatty liver of 5-10% fat? Can I fix with weight loss, no alcohol, and extra Virgin olive oil? I’m also taking 800 mg Vitamin E and milk thistle.
I looked back at an earlier response and you said RUQ pain when liver enlargement and capsule stretched. I noted the report said hyperecholic liver 17 cm. Is this large enough to create pain?
Thanks
Thanks
Brief Answer:
Gradual and mild enlargement of liver may not cause pain
Detailed Answer:
Hi.
Thanks for your appreciation and trust.
Visited the old interactions, noted today's query and investigations.
Yes, reports say no scarring and inflammation.
Ultrasound finding mild enlargement of liver and suggestive of steatosis may not be causing pain in RUQ. Development of steatosis is a slow process and hence does not cause pain.
Liver conditions causing pain are the once wherein there is fast growing lesion like abscess, hepatic amoebiasis or so. Such conditions can cause pain even on conditions like stepping down stairs, riding motorcycle or car on bumpy roads, speed breakers, deep breathing and bending. And there is pain if one percusses/slight hitting over lower chest on right side by-the-side.
Please try this and let me know if there is pain/tenderness.
If the pain level and nature is persistent over so many months this can not be due to liver conditions as the condition would have been worst over the time.
Stopping alcohol (which you already have), moderate exercises, avoid white sugar and oily foods are known to give great results in steatosis. But let us confirm by another Ultrasound and Fibroscan if at all you are having fatty liver. This will be a good follow-up too.
I had mentioned about HIDA scan in last discussions, please go ahead.
800 units of Vitamin E daily seems to be a high dose, the recommended dose is less than 400 units per day.
There are reports that Extra virgin olive oil may help, but it is better to get a re-confirmation of the condition we are discussing.
Milk thistle: sorry to tell you that I am really not aware of this.
The last query: Gradual enlargement of liver- mild to 17 cm only in a gradual way may not be responsible for the type of pain you described.
Let us see the results of review ultrasound and HIDA scan
Please tell me the type and nature of pain in RUQ, increasing factors and so on.
With Regards.
Dr T Chandrakant.
Gradual and mild enlargement of liver may not cause pain
Detailed Answer:
Hi.
Thanks for your appreciation and trust.
Visited the old interactions, noted today's query and investigations.
Yes, reports say no scarring and inflammation.
Ultrasound finding mild enlargement of liver and suggestive of steatosis may not be causing pain in RUQ. Development of steatosis is a slow process and hence does not cause pain.
Liver conditions causing pain are the once wherein there is fast growing lesion like abscess, hepatic amoebiasis or so. Such conditions can cause pain even on conditions like stepping down stairs, riding motorcycle or car on bumpy roads, speed breakers, deep breathing and bending. And there is pain if one percusses/slight hitting over lower chest on right side by-the-side.
Please try this and let me know if there is pain/tenderness.
If the pain level and nature is persistent over so many months this can not be due to liver conditions as the condition would have been worst over the time.
Stopping alcohol (which you already have), moderate exercises, avoid white sugar and oily foods are known to give great results in steatosis. But let us confirm by another Ultrasound and Fibroscan if at all you are having fatty liver. This will be a good follow-up too.
I had mentioned about HIDA scan in last discussions, please go ahead.
800 units of Vitamin E daily seems to be a high dose, the recommended dose is less than 400 units per day.
There are reports that Extra virgin olive oil may help, but it is better to get a re-confirmation of the condition we are discussing.
Milk thistle: sorry to tell you that I am really not aware of this.
The last query: Gradual enlargement of liver- mild to 17 cm only in a gradual way may not be responsible for the type of pain you described.
Let us see the results of review ultrasound and HIDA scan
Please tell me the type and nature of pain in RUQ, increasing factors and so on.
With Regards.
Dr T Chandrakant.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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